Staphylococcal Bacteremia and Endocarditis

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Abstract
• The major clinical difficulties in bacteremicStaphylococcus aureusinfections involve the following: (1) differentiation of infective endocarditis (IE) from non-IE staphylococcemias and (2) questions concerning optimum chemotherapy of deep-seated staphylococcemic infections. In this article, an algorithmic approach to the differentiation ofS aureusIE from non-IE staphylococcemias will be developed, particularly in regard to specific clinical, echocardiographic, radioisotopic, and serological "markers" for recognizing patients as at "high risk" for underlyingS aureusIE. Also, data will be presented relating to the controversies of monotherapyvcombination chemotherapy inS aureusIE as well as in bacteremicS aureusinfections caused by antibiotic-tolerantS aureusstrains. (Arch Intern Med1982;142:1169-1177)